[Federal Register Volume 71, Number 184 (Friday, September 22, 2006)]
[Notices]
[Pages 55495-55496]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 06-8021]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service


Request for Public Comment: 30-day Proposed Information 
Collection: Indian Health Service Contract Health Service Report

AGENCY: Indian Health Service, HHS.

SUMMARY: The Indian Health Service (IHS), as part of its continuing 
effort to reduce paperwork and respondent burden, conducts a pre-
clearance consultation program to provide the general public and 
Federal agencies with an opportunity to comment on proposed and/or 
continuing collections of information in accordance with the Paperwork 
Reduction Act of 1995 (44 U.S.C. 3506(c)(2)(A)). This program helps to 
ensure that requested data can be provided in the desired format, 
reporting burden (time and financial resources) is minimized, 
collection instruments are clearly understood, and the impact of 
collection requirements on respondents can be properly assessed. As 
required by section 3507(a)(1)(D) of the Act, the proposed information 
collection has been submitted to the Office of Management and Budget 
(OMB) for review and approval.
    The IHS received no comments in response to the 60-day Federal 
Register notice (71 FR 39686) published on July 13, 2006. The purpose 
of this notice is to allow an additional 30 days for public comment to 
be submitted directly to OMB.
    Proposed Collection: Title: 0917-0002, ``Indian Health Service 
Contract Health Service Report.'' Type of Information Collection 
Request: Extension of a currently approved information collection, 
0917-0002, ``Indian Health Service Contract Health Service Report.'' 
Form Number: IHS 843-1A. Need and Use of Information Collection: The 
purpose for the collection is to authorize contract health care 
providers to provide health care services to eligible IHS patients. The 
IHS form 843-1A ``Order for Health Services'' was developed 
specifically for this collection of information. Other than revising 
the title ``Purchase-Delivery Order for Health Services'' to read 
``Order for Health Services'', acquisition terms on the front of the 
form, the contract clauses contained on the back of copy 3 of the form, 
the form has not been revised and there is no change in the substance 
or in the use of the form. A copy of the form is at Attachment 2.
    The majority of the information contained in this form is completed 
by IHS staff from existing IHS automated patient and vendor data files. 
Contract health care providers complete and sign the streamlined form 
and submit it, along with a completed standard Centers for Medicare & 
Medicaid Services (CMS) health claim form (CMS 1450 (UB 92) and CMS 
1500), to the IHS for verification and payment. The CMS forms are used 
and accepted nation-wide by the health care industry and IHS is an 
approved user.
    The information collected is needed to administer and manage the 
contract health care services provided to eligible American Indian and 
Alaska Native patients. The form is used to: Authorize contract health 
care services for eligible patients; certify that the health care 
services requested and authorized have been performed by the contract 
provider(s); process payments for health care services performed by 
such providers; obtain program data; and, serve as a legal document for 
health and medical care authorized by the IHS and rendered by health 
care providers under contract with the IHS.
    The information collected is also used for: Planning for further 
care of the patient; for keeping an accurate record of the patient's 
health status and health services received and recommended; for 
planning future health care programs; for communicating among members 
of the health care team; for evaluating the health care rendered; for 
research and continuing education; and, for the provision of program 
health statistics.
    Affected Public: Individuals and households.
    Type of Respondents: Individuals.
    The table below provides the estimated burden hours for this 
information collection:

----------------------------------------------------------------------------------------------------------------
                                    Est. No. of    Responses per   Annual number    Burden per     Total annual
   Data collection instrument       respondents     respondent     of responses      response       burden hrs.
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IHS-843-1A......................           7,399              42         272,506            0.05        13,625.3
IDS*............................          13,717               1          13,717            0.05           685.8
                                 -------------------------------------------------------------------------------
    Total.......................          21,116  ..............  ..............  ..............        14,311.1
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*Inpatient Discharge Summary (IDS)

    There are no capital costs, operating costs and/or maintenance 
costs to respondents.
    Request for Comments: Your written comments and/or suggestions are 
invited on one or more of the following points: (a) Whether the 
information collection activity is necessary to carry out an agency 
function; (b) whether the agency processes the information collected in 
a useful and timely fashion; (c) the accuracy of public burden estimate 
(the estimated amount of time needed for individual respondents to 
provide the requested information); (d) whether the methodology and 
assumptions used to determine the estimate are logical; (e) ways to 
enhance the quality, utility, and clarity of the information being 
collected; and (f) ways to minimize the public burden through the use 
of automated, electronic, mechanical, or other technological collection 
techniques or other forms of information technology.
    Direct Comments to OMB: Send your written comments and suggestions 
regarding the proposed information collection contained in this notice, 
especially regarding the estimated public burden and associated 
response time, to: Office of Management and Budget, Office of 
Regulatory Affairs, New Executive Office Building, Room 10235, 
Washington, DC 20503, Attention: Allison Eydt, Desk Office for IHS.

FOR FURTHER INFORMATION CONTACT: Send requests for more information on 
the proposed collection or to obtain a copy of the data collection 
instrument(s) and instructions to Mrs. Christina Rouleau, IHS Reports 
Clearance Officer, 801 Thompson Avenue, TMP, Suite 450, Rockville, MD 
20852, call non-toll free (301) 443-5938, send via facsimile to (301) 
443-2316, or send your e-mail

[[Page 55496]]

requests, comments, and return address to: <a href="/cdn-cgi/l/email-protection#6a0918051f060f0b1f2a021b0f44030219440d051c"><span class="__cf_email__" data-cfemail="6300110c160f060216230b12064d0a0b104d040c15">[email protected]</span></a>.
    Comment Due Date: Your comments regarding this information 
collection are best assured of having their full effect if received 
within 30 days of the date of this publication.

    Dated: September 15, 2006.
Robert G. McSwain,
Deputy Director, Indian Health Service.
[FR Doc. 06-8021 Filed 9-21-06; 8:45 am]
BILLING CODE 4165-16-M


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